The purpose of this study is to determine if patients having the transversus abdominal place (TAP) block at the end of a cesarean delivery have less pain in the post-delivery period than those who do not. Freezing medication is injected between the layers of muscle on either side of the belly, to freeze the nerves that carry pain stimuli from an abdominal wound. This technique has been useful for many abdominal operations, and has recently been studied in cesarean sections, however more information is needed.
A cesarean section is a surgical procedure and, like all surgeries, there is pain after the operation. The purpose of this study is to find out if patients have less pain after a cesarean delivery when they receive an injection of local anesthetic on either side of their abdomen, into the plane of the transversus abdominis muscle. We are also interested in whether or not this injection decreases the need for other pain-killing medication during this time. Patients will randomly be assigned to receive either local anesthetic or a placebo. In addition, all patients will receive the usual standard of care and medication for pain. At 6, 12, 24 and 48 hours after the operation, patients will be asked about their pain and satisfaction with pain management. The risk of side effects is very low, as the block is done in an area with low blood supply. We propose that the addition of the TAP block to the current multi-modal regimen of post-cesarean pain management will reduce pain scores and requests for additional analgesia post-operatively, as well as increase patient satisfaction with their pain control.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
2 injections of 20mL 0.375% ropivacaine - one given on each side.
2 injections of 20mL plain saline solution - one on each side.
Mount Sinai Hospital
Toronto, Ontario, Canada
Pain score by visual analogue scale (VAS) on movement at 24 hours postoperatively.
Time frame: 24 hours
Pain at rest and on movement by VAS at 6, 12, 24 & 48 hours postoperatively.
Time frame: 48 hours
Opioid consumption at 6, 12, 24 & 48 hours postoperatively.
Time frame: 48 hours
Time to first maternal request for supplemental analgesia.
Time frame: 48 hours
Maternal satisfaction with pain management on a scale of 0-10, at 6, 12, 24 and 48 hours postoperatively.
Time frame: 48 hours
Presence of pain 6 weeks postoperatively.
Time frame: 6 weeks
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